As one component of the "NIH/DC Initiative to Reduce Infant Mortality" a comprehensive, city-wide injury surveillance system was established which collected data about injuries in children <3 years of age that resulted in an emergency room visit, hospitalization or death. Information about substantiated cases of abuse and neglect was also obtained from the Department of Family Services. Data collection is complete. For all ten study hospitals and for the one year period from October 1, 1995 through September 30, 1996, 3041 injury-related visits were identified yielding an annual event-based rate of 13.5/100 persons/year. There were ten deaths, 163 hospitalizations, and 2,868 emergency department visits. Injury rates were highest in one-two year olds and lowest in infants. Leading causes of injury varied with severity. At three of the study sites a questionnaire was administered to the parent or caregiver shortly after the injury event. Of the 1915 families who were eligible for an interview, interviews were completed for 1,351 (71%). Previous manuscripts have focused on parental sensitivities to the interview and issues related the design and implementation of a multi-hospital injury surveillance system. Recent efforts have focused on circumstances surrounding the event to identify potential prevention strategies. In these analyses, investigators identified potential prevention strategies for all events that resulted in a death or hospitalization. Potential prevention strategies were also identified for those emergency department visits in which the event was considered to present a moderate or high risk of disability or death. In total, prevention strategies were identified for 425 events. The proportion of events that could have been prevented by active, passive and regulatory strategies was determined. Circumstances surrounding injury events were examined to identify cause-specific prevention strategies. A manuscript reporting results of this study is currently in preparation.